Surgical Associates of Bozeman, PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SURGICAL ASSOCIATES OF BOZEMAN, PC

Practice address

925 Highland Boulevard
Suite 1200
Bozeman, MT 59715-6900

Phone

(406) 587-0704

Fax

(406) 587-1147

NPI assigned

Mar 7, 2007

Last updated

Aug 22, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelly L Banks, M.D.NPI 1487651766

Title

Vice-President

Phone

(406) 587-0704

Specialties & licenses 6

Addresses

Other identifiers 4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly L Banks, MD

  • Surgery Physician
  • Bozeman, MT
  • NPI 1487651766
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313971200000",
    "number": "1841320629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 HIGHLAND BOULEVARD",
            "address_2": "SUITE 1200",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156900",
            "telephone_number": "406-587-0704",
            "fax_number": "406-587-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 HIGHLAND BOULEVARD",
            "address_2": "SUITE 1200",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156900",
            "telephone_number": "406-587-0704",
            "fax_number": "406-587-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES OF BOZEMAN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2011-08-22",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "406-587-0704",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MT",
            "license": "15264",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MT",
            "license": "4000",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MT",
            "license": "6438",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MT",
            "license": "9898",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MT",
            "license": "10338",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000062917",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000048568",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000085748",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000037700",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Renee Sumter, OTRL
• Keshtisha Sunde
• Peter Scott Sunden, RN
• Sundrop Wellness
• Sunset Journey Therapeutic Services PLLC
• Susanna Turner Aprn PLLC
• Ronnaleigh Susens, CPM
• Tia Cheyenne Sutton, MSOTR/L
• John David Sveen, PT MS SCS CSCS
• Sven Bone DDS Ms PLLC

• Surgery Physician in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Surgery Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.